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Perceived Value Rules in Medicine Too – Expensive Placebos Work Best

The Placebo Effect is not a scam with no results but placebos generate real benefits and better health effects.

“How do you convert a simple saline solution into a useful treatment for people with Parkinson’s disease? Tell them it’s a drug that costs $100 per dose. And if you want to make it even more effective, tell them it costs $1,500 instead.

That’s what researchers from the University of Cincinnati discovered in an unusual clinical trial. Instead of testing a placebo against an actual drug, they pitted two placebos against each other. The only difference between the two sham treatments was their purported price.

In reality, both placebos were composed of the exact same saline solution. And yet, the patients perceived the expensive version to be more effective than the cheaper one…Both of the placebos improved motor function compared with a base line test. But when patients got the $1,500-per-dose placebo, their improvement was 9% greater than when they got the $100-per-dose placebo, the researchers reported.

In another test, 67% of the patients were judged “very good” or having “marked improvement” after they took the expensive placebo, compared with 58% of patients after they took the purportedly cheap placebo.

The researchers also used functional MRI scans to assess the patients’ brain activity and found that the “cheap” placebo prompted more action than the “expensive” one. To the researchers, this was a sign that the patients expected less from the placebo they believed cost less, so their brains responded by doing more work.

“Patients’ expectations have an important role in the efficacy of medical therapies,” the researchers wrote. Another manifestation of this is the preference many patients have for name-brand drugs instead of their generic counterparts, they added.

“Placebo can be the physician’s friend,” a pair of neurologists wrote an editorial that accompanied the study. “The outcome of this study … opens our eyes to another nuance of placebo effect.”